title: Epidemiology, anticoagulant treatment and risk of thromboembolism in patients with valvular atrial fibrillation: Results from Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER).
abstract: BACKGROUND
  The aim of this study was to perform a multicenter, prospective investigation regarding the epidemiology, the current effectiveness of therapeutic anticoagulation, and the risk of thromboembolism in patients with valvular atrial fibrillation (AF) based on the records of the Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study.
  
  
  METHODS
  Patients were selected from a total of 2,242 consecutive admissions that presented with AF diagnosed via electrocardiogram. Those diagnosed with non-valvular AF were excluded from the AFTER study population, which left 497 patients with valvular AF for analysis.
  
  
  RESULTS
  The etiology of valvular AF in patients was either attributed to rheumatic mitral valve stenosis (n = 217) or possessing a prosthetic heart valve (n = 280). Out of all the patients with valvular AF, 83.1% were taking warfarin for anticoagulation. Only 36.1% demonstrated a therapeutic international normalized ratio (INR), and among those patients it was found that 19.1% exhibited a labile INR. Multivariate analysis revealed that age was the only independent predictor of thromboembolic events in patients with valvular AF.
  
  
  CONCLUSIONS
  Many valvular AF patients are not maintained at therapeutic INR levels, which poses a threat to patient health as they age and are at greater risk for thromboembolism.
authors.affiliation: Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey. dr_hasankaya@yahoo.com.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kaya
authors.forename: Faruk
authors.initials: F
authors.lastname: Ertaş
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Kaya
authors.forename: Nihan
authors.initials: N
authors.lastname: Kahya Eren
authors.forename: Murat
authors.initials: M
authors.lastname: Yüksel
authors.forename: Bayram
authors.initials: B
authors.lastname: Köroğlu
authors.forename: Nuri
authors.initials: N
authors.lastname: Köse
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Yıldız
authors.forename: Tolga
authors.initials: T
authors.lastname: Cimen
authors.forename: Mehmet Sıddık
authors.initials: MS
authors.lastname: Ulgen
mesh_terms: D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D001777:Blood Coagulation / Q000187:drug effects; D016009:Chi-Square Distribution; D016903:Drug Monitoring / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D000925:Anticoagulants